DEP/DUA/1/38/55 (Transcript version)

William Gardner

(1785-1786)

---

Wm Gardner.

Of case of this patient reckon it necess to say but very little.

For was very little hardly subj of treat at this place.

And has now so long deserted us that, no great prosp. of again being brought to attend here.

May only obs. that when came under our care had many of those sympt. which result from pres of worms in alim. canal.

These in partic, very freq prod of such pains as here occurr.

While at same time freq. also give rise, to start & shriek in sleep, picking of nose, flushing of face & other sympt. ment. in histor of case

Presumpt arising from these strengh also by anoth circum.

Disch viz of large lumbric some months before came under our care.

Must at least be allowed, that worms often exist in alim canal, which prod of fewer sympt.

Yet taken togeth, by no means afford any cert. evid of exist.

Arise merely from worms, as giving pecul irritat to intest canal.

And may accord arise also, from any other simil irrit.

Or what may be consid as having nearly same affect, an uncomm degr of irritab.

For by this means, ordin irritat causes, afford much more powerf. infl.

And this I own, am now disp to susp, was case in pres inst.

On either view, had no great reason, to be appreh of danger.

And had ground to hope that whethr disease arose from any [im] irritat given by worms, or any simil cause, or was effect of mere irritab of intest canal, might by use of prop. remed, have been in no long time overcome.

In comm of treatm, from uncer. as to affect, thought it advis to begin with evac of intest canal

For even supp it entirely effect of irritab, was of matter conseq, to remov. every irrit cause.

And if irritat either from worm or other matters, was cause of symp, might thus obt. even compl. cure

In empl. of evac therefore, made choice of one, from which if worms pres in intest, might have exp. disch.

Accord to Tinct of Jallap, comb. with simple Syr, which have always found act as brisk, & free cathart, [presmisd] a few grains of Calomel.

From this however, though prod of very free evac in way of cathar, no worms brought away.

A circum, in my opin, afford strong presumpt that none existed.

For though may not in every case be adeq to cure, yet where worms pres rarely fails to bring some away.

And now the rather concl. that worms were not cause of affect, as after purgat patient was affected with very consid degree of tenes.

A sympt which seldom at least effect of lumbr, unless immed prev to disch.

But which often from irritab. of intest tubae.

Espec from abras of mucus, at rectum.

On this ground therefore, was led to pres a mixt. the basis of which was Theb. Tinct.

For I appreh. little doubt, that as allaying pain, & dimin dispos. to inord action, no med with which yet acq. equal to opium.

Exp. therefore, that after evac, would now be prod of best effects, both as restr. looseness, dimin tenesm, & allaying gripes.

To secure these advant & to prev. return, by strength tone of intest. comb. Laud. with an astring & aromat.

Equal parts viz of Vin Rhei & Tinct. Aromat

What however has been affect of this prescr. we do not know.

For since ordered, have seen nothing of pat. at this place.

Am however inclind to conject that dissert. has proceeded rather from having no farther occas for assist. than from any other cause.